Table 3 Challenges to interdisciplinary team work identified by teams

Clarity of vision, uncertainty and changes to service

The extent to which values are shared by team members including goals and objectives of the team and definitions of the service.

Including uncertainty at strategic level, external pressure to change and ways of managing change.

Excluding issues around clear delineation of individual roles and better understanding of others' roles/professions (5).

Excluding individual goals (6).

Communication and relationships-external

Communication and relationships with external organizations/services and senior management.

Knowledge of other services. Including external factors which affect the team and the influence of the team on external services and organizations.

Excluding issues related to change and uncertainty (3).

Communication and relationships-internal

General team relationship and communication issues.

Including team integration, clear knowledge of others' roles and meetings.

Excluding joint working, sharing skills & knowledge and reflective practices (8).

CPD, rotation and career progression

Activities aimed at professional development: training, knowledge, skills, rotation, secondment and opportunities for promotion and progression.

Including individual goals and personal issues, for example, anxiety and self-worth.

Facilities, resources, procedures and administration

Issues relating to facilities, resources and working practices and procedures.

Excluding capacity/team size, workload & time-management (11).

Joint-working

Activities related to staff members working together and observing each others’ work.

Including joint visits and assessments and shadowing opportunities.

Management, leadership, decision-making and autonomy

Explicit mentions of managers and management or leaders and leadership and euphemisms (for example. higher level), especially regarding decision making and coordination.

Includes processes of decision making within the team including decisions being made by superiors and having autonomy to make own decisions

Excluding issues covered by other codes for example, working procedures (7), staffing levels (11), clarity of goals (3), communication (4 and 5), de-briefing .procedures (13) and so on.

Morale and motivation

Issues reported to positively or negatively affect the morale of team members.

Including motivation, job satisfaction, enjoyment, pride and so on.

Patient treatment, communication, capacity and outcomes

Referral procedures/criteria, capacity and demand issues.

Including patient interventions and outcomes, and measurements of effectiveness.

Excluding communication and relationships with external services and organizations (4).

Including throughput of patients, care-needs and issues of workload and time-management.

Including communication and relationships with patients and family members.

Role mix, professional roles and responsibilities

Issues regarding the variety of roles and distribution of responsibilities currently within the team.

Including the balance between maintenance of professional roles and the need for generic working.

Excluding professional development (6) or service development activities (that is, developing/distributing skills and knowledge) (13).

Excluding team size (11), team work issues (5).

Excluding lack of clarity of roles (5).

Excluding functions ordinarily performed by external services (4).

Service development activities

Service development and team building activities.

Including case reviews and other reflective practices (for example, de-briefing procedures).

Including specific skill development across the team (for example, supporting changing roles).

Including group knowledge translation activities, for example, journal clubs and visits to other services.